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PLUMBING.INSPECTOR RECORD <br />APPROVALS ID/SIG.COMMENTS O*nq-Buildq Dc!l&r!@ <br />I h6a!y .trm 6&r pcrdty ofpdjury th.t I @ .x@pr fm thc Cdrtldr' Li@d. Law fc thc fouowirs .@@ Ga.7ot t.l !$ina <br />&d PDf.rsioo Cod4, Any Cig d C@ry which rcquir.i . p@ir to .dttuci, alrd, ihprovc, .l@olish o E lir dy ir.ucrr!, pnor lo i$i!sEc., rlro rcquiB th. appliMt ror luch pqmit ro ,il. a siF.d srrarcnr rhlr hc 6 rh. is lictuGd puru4r t! t. p@vilimi ofrh. <br />Co.uerd! Lic6.d L.w (Cn.fla 9, Clmddns with S4d6 TOoo of Diri3i6 I of $. Buin.c! ad lrofsi@ Codc) d tn{ t. or <br />shc ir adt rh@aoD ud |n. b..i! fd $c sltcs.d qsrlPri@ .Any viohrio of seri6 703 I J by 6y lrpti@r fd . pcr,nir ,ubj..l, ln. <br />opplidl to . civil FElty of not ')m thd iiw hs.Lld &ll3 (1500). <br />_I, a Mq of ti. ForE ry, d rry dploye wnh w.€6 s $ci. iol. cdpa3lrion, witt do 6. vork sd Uc sEuctuc ir not inrcnd.d <br />or otrBcd fd sal. ( 54.?0,44. Bwins dd Prcf6si6! Cod.i Th. Cdr&ror,! Lic6s. Lrw do€ sor lppty 10 e oM6 ot thc prcp.rty <br />who buil& c ihlfovB thdM, &d who do6 Du.h wort him.lf d hd.lt a lhrcu8h hii q td oM .nploy€. Fovid.d rhar such <br />inFov.lMts @ nol inmd.d d ofi6.d fG 'rlc Ii ho*ea, rh. buildins or inprcvoot is told wnhin on. ya; of cmptdion, rh. <br />OMd-Build.r wiu hsvc th. blrdd of proving thd h. or sh. not build or inprovc for tt. purpos. of sal.) <br />_1, a Mdoarhc p.oIE , e dcluiv.ly @E.tia8 with liffi.d 6tr&toE b.oNrud rlE prcjcd ( Se 704a, BsiiB dd <br />kofestio Co<L: Tt. C@addt Licd$c L.v dc nor apply ro e omcr or prcp.ny who buil& d inprovB tt.l@ , ed eho <br />corr!.l, for such proj..E enh 3 cdlErdq(o licdlcd plj!5@r ro th. cqElaor,s Li@F Llw ) <br />_l m dopt uda s..rion <br />-8. <br />& P.C. rd lnir 16@ <br />WORI(ERS COMPENSAIION Df,CLANATION <br />I hftby affim ud.r podry ofpajlr, on. of tn. followinB d.cle.ti@: <br />_! h.v. od sillhairtlin &Cdifi6r. of C@alro S.lf-lnsu. fd wnt6 cmpasarid, s FDvid.d fr by Scrioi t iOO ofrh. <br />rlbm Cod., f{lh. pdfdl@e of $. p6t fd which rhc Frnil h isud <br />_l ha!. &d will mirlaiD wqkc6' conptuation iNurs@. s rcquird by S@rion ITOO oflhc Llbor Cod., for lhc pcrfom&@ of6c <br />work fc which thi! Fmit is isucd My vork6' compasalio insutucc 6iq ed poticy numb.. dc <br />Cnid <br />(Tr'is lation n*d nor b. .npl.r.d il $. pqmn h for oDc h@d..n dolte (t I ool d lcss) <br />,Zu*^^^ <br />F-.-6i."ro,tE pdfm&c. ol th. wot fd whic[ lhi! psnn <br />th. eo*6 ' cm!@!!a@ lss of Cdifdi.. ad <br />comp.ns.d@ proeisi@s of kbor Co.L, I sh.ll, fonhPith <br />WARNING: Fdl@ |o sE wort6 .ohpoEcio @vdigc ro dimio.l paallid 6d civil <br />finq up 10 o. hu(fld lholed &,lla (l I oo.Ooo),ii ,.Uitio. <br />0!. Llbc Codc. inraBt ed lnmcyb f.€. <br />. d.haAa a prcvidc! fd lhc Setion 3076 of <br />I h6.by a6im uDd6 p.n.lty <br />the Bqin* Md lrof*itu <br />ofFjuy $atI6 ricord uidrprceision <br />Cod., d my lic6s. t in tull fm. dd.6cct <br />I t@!y dEm sda padty of D.o{ry 60 Od! i, . .et'ud@ <br />isud(Soc 3097, Civ. c.). <br />ofthr wuk io. which $i5 Fmit i! <br />AI'PLICAN?S DACLAII"{TION <br />Dqnolido rmjt3-Alb61oc Nolinoti@ Fcdaal R.gu.rioo! (Tid. aO, lst 6) <br />_ R.quir.! LlBo ofNodficatioi <br />? <br />-tyy!tul]l'. <br />t.ed rcEuleou rlsurlin8 <br />L l cmify n\at I h.v. @d fir! mrhcltior .nd <br />ordineG dd Sht LlB Elllins ro blildin8 CiV dd Coo.ty io ot r upon <br />.!ovc hdri6.d prcDcny ld inrp..ri6 <br />UNDER GROUND <br />Waste & Vent <br />Water-Underfloor <br />Gas-Underfloor <br />Buildin Sewer <br />Area/Storm Drain <br />lnterceptor/ Clarifier <br />TOP OUT <br />Waste & Vent <br />Water Piping <br />Gas Pipeing <br />Roof Drain <br />Tub/Shower Test <br />Rough Water Heater <br />POOUSPA <br />P-trap/Drain Line <br />Jvlain Draini Pool Piping <br />Fill Line/Back Flow <br />Pool Heater/Gas Line <br />Misc <br />Gas Service <br />Lawn Sprinkler <br />Sanitary Sewer/Cap <br />Back Flow Device <br />BguSL Plumbing EIF IFED <br />Final Gas Test <br />Meter Release rEo I I 4UIJ <br />EAMC 843,7 <br />FINAL <br />Notes, Remarks, Etc. <br />DATE <br />D{. Oue <br />Water Service <br />?90. ssa *